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    OpenPayerNPI Medicare & MedicaidMennonite General Hospital Inc
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    Mennonite General Hospital Inc — Billing Profile & Reimbursement Data

    NPI 1043347768 · Aibonito, PR · Specialist

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    Mennonite General Hospital Inc is a specialist provider located in Aibonito, Puerto Rico. This profile covers 0 Medicare and 102 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationMennonite General Hospital Inc
    AddressCalle Jose C Vazquez
    CityAibonito
    StatePR
    ZIP00705
    TaxonomySpecialist
    NPI EnumeratedFebruary 28, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$8.3M
    Medicare$0

    Key Findings

    MENNONITE GENERAL HOSPITAL INC is effectively a single‑payer Medicaid provider: there is no Medicare billing on file while lifetime Medicaid revenue is reported at $8.3M, indicating the provider’s measurable revenue flow in this data set is concentrated entirely in Medicaid. This payer mix means analysis, contracting, and utilization patterns should focus on Medicaid behavior rather than Medicare comparisons.

    Revenue concentration is high: the precomputed top three Medicaid codes (99232, 99213, 99070) together account for 40.0% of this provider’s total Medicaid revenue, with 99232 representing $1.5M (18.8%), 99213 $1.1M (13.8%), and 99070 $589.6K (7.4%). This level of concentration around a small number of evaluation/management and supply codes suggests a narrow set of revenue drivers to monitor for utilization and reimbursement trends.

    The code mix indicates a hospital-based service profile with heavy inpatient and emergency throughput. High-volume inpatient codes such as 99232 (subsequent inpatient care) and 99221 (initial inpatient care) appear alongside ED codes 99283/99282 and discharge code 99238, which together point to continuous inpatient/ED operations rather than an outpatient-only clinic model.

    MENNONITE GENERAL is a dominant state-level provider for several high-volume codes: 99232 ranks #1 of 456 providers in-state (100th percentile; labeled an "extreme outlier") and 99070 ranks #1 of 225 providers in-state (100th percentile; "extreme outlier"). These rankings indicate the hospital reports far higher state volumes for these services than typical peers and is a major competitor for inpatient follow-up and supply-related billing in Puerto Rico.

    Several other codes reinforce the hospital’s advanced service offerings: 93458 (imaging supervision/interpretation for coronary angiography) generates $435.4K and ranks #4 of 36 in-state (91st percentile), and 99291 (critical care) produces $184.2K and ranks #4 of 43 (93rd percentile). The presence and revenue from these codes indicate active catheterization/diagnostic cardiology and critical care capacity beyond routine E/M visits.

    While some high-volume office/outpatient codes are present, their comparative standing varies: 99213 is responsible for $1.1M (13.8%) and ranks #89 of 3229 in-state (97th percentile) but is described as a "typical, unremarkable" volume for that code, whereas 99203 and 99202 are state outliers (99203 rank #1 of 1397 and 99202 rank #2 of 318, both flagged as extreme outliers), suggesting unusually large new‑patient outpatient volumes relative to many peers. This mixed competitive profile means the facility is both a routine outpatient/E/M provider and an outlier for certain new-visit categories.

    Operationally, the facility reports substantial usage of ancillary diagnostics and procedures that support an acute‑care hospital: ECG codes 93040/93000 and CT abdomen/pelvis codes 74177/74176 appear in the top code list, with 93040 ranking #1 of 6 in-state (100th percentile; notably above typical) and 74177 contributing $233.4K. These patterns are consistent with an integrated ED/inpatient imaging and cardiology diagnostic workflow that generates a meaningful share of Medicaid revenue.

    The provider has long tenure in the enumeration file (NPI enumerated 2007-02-28, approximately 19 years ago), indicating sustained presence in the market. Combined with the extreme outlier rankings on multiple high-revenue codes, this tenure supports the interpretation that MENNONITE GENERAL is an established, high-volume Medicaid hospital in Puerto Rico whose financial profile and utilization are concentrated in inpatient E/M, supplies, and acute diagnostic/cardiac services.

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    102 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99232The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…40,360$40$1.5M
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…31,210$40$1.1M
    99070Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,…26,800$20$589.6K
    99221The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…13,390$40$575.7K
    99203The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…13,610$40$571.5K
    99283The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.8,180$60$482.9K
    93458In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…1,180$370$435.4K
    99202The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…13,550$30$420.1K
    93040The provider records the electrical conduction of the heart to examine any abnormality in its functioning using a maximum of three leads, wires that connect the recording device to electrodes placed…16,200$20$356.3K
    99282The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.9,550$40$343.8K

    Showing 1–10 of 102

    • More pages

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Puerto Rico median

    102 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    93458In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…44080$680$318.5K
    66984The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…4260160$380$270.5K
    88142The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…4150370$20$247.3K
    74176The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.3380900$110$242K
    93306The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…183210380$210$230.1K
    74177The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.1470730$110$178.7K
    77067The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…871501,180$70$170.3K
    92928The provider inserts a catheter through the skin (percutaneous approach) and guides it into the heart's arteries. They deploy one or more stents (small tubes) to keep the artery open and may expand a…610160$500$163.9K
    19083Under ultrasound guidance, the provider takes breast tissue percutaneously from a single lesion for biopsy. He may place a localization device at the same time.310190$350$153.1K
    43239The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.77110270$280$148.1K

    Showing 1–10 of 102

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    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Mennonite General Hospital Inc, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mennonite General Hospital IncPRGeneral Acute Care Hospital$0$2.8M
    Carlene Cadiz FuentesPRObstetrics & Gynecology Physician$0$1.2M
    Wilfredo De Jesus RojasPRPediatric Pulmonology Physician$0$1.2M
    Jorge Colon MartinezPRGeneral Practice Physician$0$729.7K
    Pedro PerezPRGeneral Practice Physician$0$668K
    Fabio Ricci GorbeaPRInternal Medicine Physician$2.1K$630.9K
    Walisbeth Class-vazquezPRGastroenterology Physician$7.7K$492.6K
    Jesus Rodriguez RodriguezPRGeneral Practice Physician$6.6K$224.2K
    Juan Malpica-santiagoPRPulmonary Disease Physician$33.2K$148.3K
    Jeffrey ZuckermanPRDiagnostic Radiology Physician$131.1K$2.1K

    Nearby Providers

    Other providers in the same ZIP code as Mennonite General Hospital Inc, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Sandra Gracia-lopezPRNuclear Medicine Physician$26.7K$4.1M
    Arecibo Pathology Services CspPRAnatomic Pathology & Clinical Pathology Physician$0$3.8M
    Clinica Oftalmica De La Montana, C.s.p.PRExclusive Provider Organization$0$2M
    Marie LugoPRSports Medicine (Physical Medicine & Rehabilitation) Physician$1.1K$1.7M
    Vital-care Medical Center L.L.C.PRMulti-Specialty Clinic/Center$0$1.3M
    Juan RayaPRGeneral Practice Physician$0$1.1M
    Clinica De Manejo Del Dolor Dr Crawford W Long C S PPRPain Medicine (Anesthesiology) Physician$0$1M
    Nestor Sanchez ColonPRDermatopathology Physician$34.6K$992.5K
    Janice Del C Rolon MarreroPRClinical Medical Laboratory$2.2K$951.2K
    Jose GarciaPRCardiovascular Disease Physician$7.5K$939.7K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Puerto Rico Providers
    7 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Puerto Rico Distribution
    Mennonite General Hospital Inc — 13 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Puerto Rico